Wednesday, June 24, 2009

Treatment Guidelines


In December 2008, the American Academy of Orthopaedic Surgeons (AAOS) published their review of the research behind the various treatments for the osteoarthritic knee.


The paper looks at options other than knee replacement. They take a very strict objective view not only looking at the research conducted but also the quality of the data produced.


Anyone who is brave enough can look at the full 263 page report here.


I have had a look through it and there are few surprises.


Getting the thumbs up are:


Losing weight

Low Impact aerobic exercise

Self-management programs such as those by the Arthritis Foundation

Quadriceps strengthening

Non-steroidal Anti-inflammatory medication


Still Inconclusive - more study required:


Bracing for uni-compartmental arthritis

Acupuncture

Intra-articular Hyaluronic Acid injections


Not Recommended:


Lateral heel wedges

Glucosamine and / or Chondroitin sulfate or hydrocloride



The main discussion point would be the Glucosamine / Chondroitin recommendation. Although there were studies that showed a positive effect they were deemed weak studies with the potential for error. It is likely the larger, scientifically more powerful studies will be published in the future and it will be interesting to see how this one pans out.


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